ABSTRACT
In Romania, the immediate effects of the pandemic have revealed a strain on food supply chains due to the limitations related to social distancing between producers/deliverers/consumers. The paper aims to identify and analyze the resilience of small farmers in southern Romania (i.e., Bucharest Metropolitan Area) to the new conditions imposed by the COVID-19 pandemic. By combining quantitative and qualitative approaches, the analysis focused on the COVID-19 pandemic pre-conditions, impacts and resilience, as well as the post-COVID-19 solutions - the medium- and long-term measures necessary to sustain the effort of the farmers to cope with risks and uncertainties in the future. The study shows a close connection between some pre-existing conditions and farms capacity to become resilient to the shocks caused by the pandemic. Hence, organic farms demonstrated the highest resilience, while leisure and recreational farms the lowest. The research has improved the existing knowledge on the sub-urban farmers as key players of metropolitan agriculture and promoters of sustainability and food security for cities and identified some elements of resilience during COVID-19: reconnecting with local food production, networking, door-to-door delivery, multi-functionality inside the farm, etc. Particularly, backing small farmers to meet market requirements and access digital marketing are among the key measures to support local food systems and short food supply chains to adapt to future shocks.
ABSTRACT
Emery-Dreifuss muscular dystrophy (EDMD) is a rare genetic disease that affects the musculoskeletal system, including the heart, causing rhythm disorders and cardiomyopathy, sometimes requiring an implantable cardioverter-defibrillator (ICD) or heart transplantation due to severe heart damage. The case described herein concerns a 16-year-old girl, with grade II obesity, without other known pathological antecedents or cardiac pathology diagnosis given an annual history of cardiological investigations. She was admitted to the Infectious Diseases Department with SARS-CoV-2 virus infection. The anamnesis showed that the cardiological investigations performed in the past were completed due to the medical history antecedents of her sister, who had been diagnosed with dilated cardiomyopathy, having undergone the placement of an ICD and a heart transplant. Numerous investigations were performed during hospitalization, which revealed high levels of high-sensitive cardiac troponin I (hs-cTnI), creatine kinase (CK) and N-terminal pro b-type natriuretic peptide (NT-proBNP). Dynamic electrocardiographic evaluations showed ventricular extrasystoles, without clinical manifestations. The patient presented stage 2 arterial hypertension (AHT) during hospitalization. A cardiac ultrasound was also performed, which revealed suspected mild subacute viral myocarditis with cardiomyopathy, and antihypertensive medication was initiated. A heart MRI was performed, and the patient was diagnosed with dilated cardiomyopathy, refuting the suspicion of viral subacute myocarditis. After discharge, as the patient developed gait disorders with an impossible heel strike upon walking and limitation of the extension of the arms and ankles, was hospitalized in the Neurology Department. Electrocardiograms (ECGs) were dynamically performed, and because the rhythm disorders persisted, the patient was transferred to the Cardiology Department. On Holter monitoring, non-sustained ventricular tachycardia (NSVT) was detected, so antiarrhythmic treatment was initiated, and placement of an ICD was subsequently decided and was diagnosed with EDMD. Genetic tests were also performed, and a mutation of the lamin A/C gene was detected (LMNA gene exon 2, variant c448A > C (p.Thr150pro), heterozygous form, AD).